HomeMy WebLinkAboutP2019-0281 - Permitsu City of Newport Beach - Building Division
a 100 Civic Center Drive, Newport Beach, CA 92660
r Permit Counter Phone (949)644-3288
Job Address: 266 EVENING CANYON RD Bldg: 1 Floor: Suite:
Description of Work: PLUM GASLINE TO BBQ & FIREPIT
Inspector Area: 5 Code Edit 2016
Legal Description: N TR 1116 LOT 60
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Owner: HAGGARD AMY
Contractor:
LAND ART BY SAEMAN INC
Address: 266 EVENING CANYON
Address:
PO BOX 929
NEWPORT BEACH, CA 92625
FEES.
DANA POINT CA 92629
Phone: 949-958-2884
Phone:
949-701-3826
Con State Lic:1028864
Issued Date:09/11/2019
Lic Expire:
07/31/2021
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Bus Lic:
BT30058441
Processed By: C/l/../'I \
Lic Exp Date:
03/31/2020
PLUMBING Permit: P2019-0281
Project No :
Inspection Requests Phone (949)644-3255
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FEES.
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Kitchen Fixtures
Misc.
Worker's Compensation Insurance -
•
• • • • -
Carrier: SECURITY NATIONAL
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Policy No:SWC1232327
$0.00
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Expire : 04/01/2020
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40
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 8:00 p.m.
FEES.
Bathroom Fixtures
Kitchen Fixtures
Misc.
Misc.
Other
Toilet:
0
$0.00
Kitchen Sink:
0
$0.00
Water Piping:
0
$0.00
Roof Drain: 0
$0.00
$0.00
Bidet
0
$0.00
Garbage Disp:
0
$0.00
Water Softener:
0
$0.00
Grease Trap: 0
$0.00
$0.00
Urinal
0
$0.00
Bar Sink:
0
$0.00
Water Heater:
0
$0.00
Grease Interceptor:0
$0.00
Bath Tub:
0
$0.00
Vegetable Sink:
0
$0.00
Gas up to 4 outlets:
1
$7.00
P -Trap: 0
$0.00
Record Mgmt Fee:
$0.00
Shower Stall:
0
$0.00
Ice Maker:
0
$0.00
Gas over 4 outlets:
0
$0.00
Sewer
Investigation:
$0.00
Wash Basin:
0
$0.00
Dishwasher:
0
$0.00
Backflow up to 2":
0
$0.00
Sewer: 0
$0.00
Plan Check:
$0.00
Hydro -Mass Tub:0
$0.00
Lndryfrrap:
0
$0.00
Backflow over 2":
0
$0.00
Sewer Alter/Repair.0
$0.00
Issuance:
$35.00
Floor Sink:
0
$0.00
Regulator:
0
$0.00
Hose Bibb:
0
$0.00
Sewer Abandon: 0
$0.00
Supplemental Fee:
$0.00
Floor Drain:
0
$0.00
Lawn Sprinkler:
0
$0.00
Drinking Fountain:
0
$0.00
Additional Fee :
$0.00
TOTAL:
$42.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance: $42.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 8:00 p.m.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) z
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code)) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than fine hundred dollars ($500).
IJ I, as -owner of•the.••property, or my employees with wages as their sole compensation, will do (_) all of or (, portions of the work, and the structure is not intended or offered for sale (Section 7044,
$L3i iss and•�roPe§Bions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
jmprgvements'Ardltot intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
pim�prs fed for the purpose of sale).
�s owner et�the pEoperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
a to an
ow
he
property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
am exempt kom licensure under the Contractors' State License Law for the following reason:
.•••.
�y my sgnature kalawi acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cahoot legally
• • mye a structure Oat I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
• PtWISEion, rode, igg available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
6ignature of PR 04e Owner or Authorized Agent Date
...... LICENSED CONTRACTOR'S DECLARATION
'I.FIe}'r affirm,dnder have
of perjury that I am licensed under provisions of Chapter 9 (commencing with ection 7000) of Division 3 of the Busine*TTHOUSAND
de, and my license is in full force
and effect. •
License Class License No Date �� Contractor SignatuWORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE-WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN
Eormance of the work for which this permit is issued. Policy No.
ve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation
ce carrier and policy number are:
Policy Number
Date
is of Agent I -none rF _
certify that, in the perfo ance of the ork for which this permit is issued, I shall not employ any person in any manner so as to become subject
if I should become su je rkem' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prove
nature of Applicant C/
CLARATION REGAINPZCONSTRUCTION LENDING AGENCY
Ireby affirm under pqnalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
Ider's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I h e provided is correct.
1 agree to comply with all applicable city and cou ordinanC I and state laws relating to building construction.
I authorize representatives of this city or county j e a ve-identified property for inspection purposes.
nature of Propertv Owner or Authorized Agent Print Property Owner's or Authorized Agenl
workers' compensation laws of California, and
VI I A rl
(Section 3097, Civil Code).
a
ACDON
DATE
BY
DECLARATION OFCOMPUANCEMTNCOOEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF7ITLE40AIVD
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